
Objective: To study the maternal and neonatal outcome in multifetal gestation in a tertiary care centre Method: A retrospective observational analysis of 152 twin pregnancies admitted and managed at Govt. Rajaji Hospital, Madurai from May 2016 to april 2017 was done. Patients were studied for any adverse antenatal complications, mode of delivery and pregnancy outcome both maternal and perinatal. Results: Most common indication for admission was threatened preterm labour, Anaemia, Non severe preeclampsia. Out of the 152 patients 77 delivered at GRH(50%), others delivered at their native places, out of which 44 delivered by vaginal route (57%) whereas 33(42%) had to undergo caesarean section. Malpresentation of the first twin was the commonest indication (42%) for caesarean section. Out of the 77 women of twin pregnancy giving birth to 142 live-born babies, out of which 3(2%) were single fetal demises, and 9(6%) died due to complications related to prematurity: hyaline membrane disease, hyperbilirubinemia. Conclusion: The risk of pregnancy related complications in twin gestation are definitely more than a singleton pregnancy. Early detection and proper management of twin pregnancies can reduce the complication rates thereby improving maternal and neonatal outcome